Who is getting US NGO’s grant for cleft lip, palate surgeries?

Most patients operated at govt expenses at MayoHospital, but a plastic surgeons’ organisation continues to claim money from Smile Train; Prof Mustehsan calls for probe; Prof Farid denies link with claims

LAHORE

Grant provided by an American organisation for cleft lip and palate surgeries to a Pakistani organization has not been utilized as most patients were operated upon at Mayo Hospital, Lahore, at government’s expenses, reveals the record of cases sent to this foreign agency to claim the money.

The Smile Train, a non-governmental organization based in New York, US, has entered into an agreement with a local welfare organization Foundation of Friends of Plastic Surgery on July 19, 2012 to put smiles on desperate faces.

The documentary evidence, available with The News, revealed that Dr Farid Ahmad Khan, Professor of Plastic Surgery, currently serving as Chairman/Dean of Shaikh Zayed Hospital, Lahore, finalized the agreement with Smile Train on behalf of the Foundation of Friends of Plastic Surgery. The validity of this agreement was extended from January 1, 2014 through December 31, 2015, for 400 surgeries over a 24 month term at a contribution rate of $220 per surgery. This equalled a total grant up to $88,000 USD, it was revealed in the document available with The News.

The official document, available with The News, has revealed that Foundation of Friends of Plastic Surgery is registered with Joint Stock Companies, Lahore, on June, 4, 2012. Dr Farid Ahmad Khan is Vice President, his mother Zaib-ul-Nisa Begum is President and his wife Dr Samra Farid is its Finance Secretary with their residence 25-C-I, Sadar Street, New Muslim Town, Lahore, as its official address. Since July 2012, sources told The News, the Foundation has sent details of as many as 357 patients of cleft lip and palate to Smile Train including 281 surgeries conducted at Mayo Hospital and six at Shaikh Zayed Hospital in public sector as well as 68 operations conducted at a private hospital on Zafar Ali Road and two operations conducted at another private hospital in Mozang area in Lahore.

“The Foundation has sent the pre- and post-surgical evidence of patients by four different surgeons to Smile Train,” claimed the sources, who further revealed that Dr Farid Ahmad Khan had 236 patients to his credit and Dr Mustehsan Bashir, Associate Professor and Head of Plastic Surgery Department, Mayo Hospital, performed 99 cleft lip and palate surgeries.

The patients’ evidence on behalf of both these surgeons is still being sent to Smile Train as the other two surgeons Dr Muhammad Abbas with 14 operations and Dr Rafique Mirza from Shaikh Zayed Hospital with five surgeries had not conducted the operations since November 2012 and September 2015 respectively.

During the last three years, the documents revealed, Dr Farid had 151 cases to his name from Mayo Hospital including 33 in 2014, 52 in 2015 and 66 in 2016, while Dr Mustehsan’s had 20 cases to his name during same period including 13 in 2014, nil in 2015 and 7 in 2016. After his departure from Mayo Hospital as Professor and Head of Plastic Surgery Department and joining as Chairman/Dean of Shaikh Zayed Hospital, Lahore with effect from 11-04-2015, the sources informed, Dr Farid Ahmad Khan had 99 patients’ surgeries performed at Mayo Hospital to his name till date with last surgery of a patient Jannat Fatima conducted on 28-11-2016. He also has one patient’s surgery to his credit at Shaikh Zayed Hospital. Similarly, Dr Mustehsan Bashir’s last case, Momina Intazar, sent to the Smile Train was operated on 22-12-2016.

The sources further claimed that any civil servant working with any international organization was a violation of the law under Civil Servants (Amendment) Act, 2016, which under Section 10A Restriction on service in international organization, sub-section 1 says, “No civil servant shall, during his service, serve in any international organization, including an international non-governmental organization, international financial institution and foreign donor agency”.

“Dr Farid didn’t discontinue working for Smile Train even after the promulgation of the Act last year although the Foundation entered the agreement in July 2012 and amended with effect from January 1st 2014,” the sources alleged, and added there was a need to check other civil servants/plastic surgeons in Pakistan, who were partners of Smile Train under the same program despite the promulgation of the Act last year.

When Smile Train was approached at its Worldwide Headquarter in the US for an email inquiry regarding agreement with its partner organization Foundation of Friends of Plastic Surgery and Dr Farid Ahmad Khan in Pakistan, it declined to provide the requested information. “In respect of maintaining patient confidentiality we do not share detailed medical information,” says Shari Mason, Vice President, Marketing Communications.

Talking to The News, Dr Mustehsan Bashir, Head of Plastic Surgery Department, Mayo Hospital, categorically denied his or his Department’s any direct agreement with Smile Train vis-a-vis grant per patient, saying that the cleft lip and palate patients were being treated in Mayo Hospital at government expenses.

He said that he along with some other surgeons had initially registered with Smile Train through the Foundation of Friends of Plastic Surgery after its contract with the Mayo Hospital duly signed by Medical Superintendent of the hospital. He said that Smile Train might have the record of his patients submitted through the Foundation during that initial period, but the practice was stopped after the departure of the then Head of the Department due to his posting as Chairman of Shaikh Zayed Hospital.

“I discontinued case submission on behalf of the Foundation for Smile Train after January 2014. It is unbelievable if cases are still being sent to Smile Train with my name or even with Dr Farid’s name as the latter was no longer serving in the Mayo Hospital,” he said, adding that there must be a serious breach in patients’ record in the Department. “It needs to be investigated and it will be investigated.” He revealed that similar issues had cropped up in respect of Smile Train in the past too where some surgeons posted fake cases as evidence to claim the money.

However, he said that Foundation of Friends of Plastic Surgery under an agreement with Smile Train had set up a fund worth of 50 or 60 thousand rupees per annum in the Department to be used to upgrade certain facility such as library or to purchase instruments on emergency basis, etc. Similarly, Burn Children Charity Organization also extends financial support to the Department of Plastic Surgery for renovation/up-gradation purposes.

When contacted, Prof Dr Farid Ahmad Khan informed that Foundation of Friends of Plastic Surgery had entered into an agreement with Smile Train not just to provide free treatment to cleft lip and palate patients but also impart training to PG residents in Mayo Hospital, because most of the plastic surgeons associated with Smile Train were performing surgeries in private hospitals, which though helped free treatment to patients but badly affected PG residents’ training in government sector. However, he categorically denied any relation with the Foundation in any official capacity, saying that he like other surgeons had been registered with the Foundation only to provide services as plastic surgeons. However, he said that he had not been doing any surgeries since he left Mayo Hospital and posted as Chairman of Shaikh Zayed Hospital in April 2015. “It is simply out of question that patients’ cases from Mayo Hospital with his name are being submitted to Smile Train,” he said, while declaring any document in this regard as “fake”.

“We, as professors, are not supposed to do cleft lip and palate surgeries but to supervise PG residents to perform such surgeries to impart them hands-on training,” he said, adding that the cleft lip and palate patients in Mayo Hospital are operated upon by the PG residents, which can be cross-checked with patient record in the Department of Plastic Surgery.

However, he said that there might be a possibility that his name was still mentioned in any website on the Internet for he had remained associated with Smile Train through the Foundation while serving in Mayo Hospital. To a question, he said, no cleft lip and palate surgeries have been conducted in Shaikh Zayed Hospital on behalf of the Foundation.

He further said that he had been supporting poor patients in a private hospital on Zafar Ali Road through Smile Train’s grant of 10 to 12 thousand rupees per patient with contribution from Zakat and donation as cost of cleft lip and palate surgery was quite high in private hospital.

He informed that he had helped set up a Smile Train’s fund in Mayo Hospital for up-gradation of facilities or purchase of necessary items for Department of Plastic Surgery.

When asked about status of agreement with Smile Train after the promulgation of Civil Servants (Amendment) Act, 2016, he said that it was an eye-opener for all plastic surgeons having an agreement with Smile Train, adding that he had no direct agreement with the international organization as he was only providing services to the local Foundation.

“I was considering seeking Smile Train’s support to establish Plastic Surgery Ward in Shaikh Zayed Hospital but will now drop this idea and withdraw services for the Foundation in order to completely disconnect with the Smile Train,” he added.